I’m sure you’ve always been advised to see your dentist in the event of a toothache. But this advice isn’t all that helpful if you can’t see your dentist right away and the tooth pain is unbearable.
How does one tooth cause so much pain? And what are the best ways to stop a toothache and get out of pain until your next appointment?
This article will answer both of those questions. I’ll also reveal some common mistakes you could be making that might make your pain worse.
First, let’s take a look at the most common causes of tooth pain, then the best ways to get tooth pain relief.
Common Toothache Causes
Inflammation and Cavity Pain
Inside each of your teeth is living tissue with an artery, a vein, and a nerve.
These parts of the tooth give the tooth sensation to pressure, hot, and cold. They can also get inflamed and/or infected.
Certain bacteria in your mouth excrete acids that bore their way through tooth enamel (the hard, white outer coating of teeth). Once the bacteria pass through the enamel, they gain access to the inside structure of the tooth, called dentin.
Dentin is soft and sponge-like with tubules, so it isn’t as strong against the invading bacteria as enamel.
Once the bacteria access the dentin of a tooth, the dentin responds with inflammation. And, most often, pain accompanies inflammation.
Let me explain how.
When you cut your hand, there’s room for the tissue around that cut to expand and swell. It’s on the surface of your skin, so there’s nothing stopping that expansion.
But inside the hard enamel walls of a tooth, swelling dentin has nowhere to go. The inflammation still occurs, however, so pain is caused as the swelling pushes against the outer enamel.
This explains why toothaches are so excruciating, and why they’re rather unique. Nowhere else in the body does inflammation or infection trigger pain of this sort. (And this is why the 3-3-3 method, explained below, works so well: it reduces the swelling.)
The sensation of pain in the teeth due to inflammation and infection is also called cavity pain. Tooth decay and cavities are literally infection of the dentin, and the larger the infection, the worse the inflammatory pain.
You might not realize this, but cavities (dental caries) are a disease, not just surface damage to the teeth. (1)
If you’re having mild, infrequent tooth pain, it might be caused by something less serious than a cavity: root sensitivity.
One easy way to test for root sensitivity is to monitor your toothache after eating sugary foods.
If the pain is more pronounced after eating candy or drinking soda, there’s a good chance that you’re experiencing root sensitivity.
It hurts, of course, but it’s not a cavity or cause for a root canal.
Root sensitivity occurs when things like acidic foods have worn away at the dentin in your tooth.
The root of the tooth is very sensitive to ions, and sugar is an ion, which is what causes the pain. It’s the same reason you might get pain if a metal fork touches your tooth, or if you were chewing on aluminum foil.
Cavities, by comparison, are usually painful when exposed to heat and/or cold.
Less Common Causes of a Toothache:
- Food getting stuck between your teeth, especially if your teeth have spaces in between them (this becomes more common with receding gums)
- Trauma to the tooth, including injury or grinding your teeth
- A sinus infection that can be felt as pain in the teeth
What To Do at the First Sign of a Toothache
Not all toothaches are an emergency. Some are, however, so it’s important that you know how to respond accordingly.
As mentioned, root sensitivity is a non-life threatening cause of tooth sensitivity that your dentist can help with. It’s fine if you experience this pain at night over the weekend and can’t see a dentist until the next day or two—root sensitivity doesn’t need to be immediately addressed.
On the other hand, pulpitis (typically resulting from a cavity, decay, or damage to the tooth), is an infection of the pulp in the tooth that must be treated quickly.
If it’s not, it can lead to reduced blood flow to the pulp. At this stage, the tooth may require a root canal or extraction.
Pulpitis is also one common type of pain after dental work, so if the affected tooth was recently worked on, get to the dentist as soon as you can. Some pulpitis infections are irreversible (which would result in the need for a root canal).
There are several other causes of tooth pain ranging from mild to severe, but the following guidelines are useful in determining how quickly you need to act.
If you’re experiencing mild tooth pain that comes and goes within a few seconds, particularly when eating sugar or hot and cold foods, make note of it.
Bring it up the next time you have your regular dental appointment, which should be every six months. The same goes for mild or moderate pain that disappears after a day or two.
Moderate to severe pain that lasts for more than a day or two is worth an immediate visit to the dentist.
If the dentist isn’t able to meet with you immediately, the 3-3-3 method below can help with pain and inflammation until your visit. However, don’t put off going to the dentist.
If you have a severe toothache with a fever or swelling, or your face has fallen and your dentist hasn’t gotten back to you within an hour, go to the emergency room.
The infection in this scenario is serious enough that you’ll want to get appropriate treatment from a medical professional without delay.
The 3-3-3 Method for Toothache Pain Relief
Again—and I can’t stress this enough—if you’re experiencing intense, lingering tooth pain, you should see a dentist as soon as you can.
But if you can’t get to a dentist, like on a weekend or while traveling, the 3-3-3 method for toothache pain relief can hold you over until you can see a dentist.
When getting out of tooth pain, it’s all about controlling the swelling. Reduce the swelling, and you reduce the pain.
This premise is the foundation of the 3-3-3 Method, which is:
- 3 Advil (600 mg total)
- 3 times a day
- For 3 days
A word of caution: When following the 3-3-3 Method, don’t stop taking the Advil before 3 days have elapsed—even if you feel better.
The goal is to reduce inflammation as well as pain, and once you back off, it takes a while for the medication levels to build back up enough to control the inflammation.
Additionally, you need to keep in mind that this method can’t do anything to address the root cause of your tooth pain. You will need to see a dentist to address the underlying issue.
Consistent tooth pain is almost never resolved on its own, so don’t use this method for anything else except tiding you over until your dentist appointment.
You may also need to check with your doctor to confirm whether you can take ibuprofen. If you can’t, there are some home remedies for tooth pain that may also work to ease your toothache until you’re able to see your dentist.
The Best Home Remedies for Toothache Relief
If you can’t take ibuprofen (Advil), or try to avoid medications when possible, there are several natural methods you can use to reduce the pain of a toothache.
1. Salt Water Rinse
Salt water rinses are one of the first ways I recommend you treat a toothache at home.
To make my super-saturated salt rinse, pour a glass of warm to hot water (boiling isn’t necessary) and slowly stir in either Himalayan or dead sea salt until you see salt crystals at the bottom that are no longer dissolving.
Rinse with this solution 4-5 times daily to reduce inflammation and contract the tissues. This rinse is especially effective with gum pain and foreign body response to something like a poppy seed stuck in between the gums.
Add in warm to hot water
Sherpa Pink Himalayan Sea SaltRich in Calcium and other minerals that help boost the remineralization process of the body and especially the teeth.
2. Clove Oil
Clove is an essential oil that may provide pain relief as strong as benzocaine (Orajel). (2)
It’s important to note, however, that the active ingredient in clove oil is eugenol. Although eugenol occurs in nature, synthetic versions carry some safety concerns, according to the EWG. (3)
Clove oil also has antibacterial properties, which means it can kill beneficial bacteria in the mouth an cause an imbalance in the oral microbiome.
For this reason, I don’t recommend using this remedy for more than a couple of days.
To use clove oil to treat a toothache, apply a very small amount to a cotton swab or piece of tissue and apply gently to the affected area.
This works well if there is an exposed nerve due to a deep cavity. Specific placement of the clove oil is crucial for success—it will only work if you place the oil near the pulpal tissue (the inner substance of the tooth).
Most health food stores have clove oil for a few dollars a bottle. Stick with high-quality essential oils to avoid any synthetic fillers. I like the NOW brand.
3. Grab a Pillow
Keeping your head elevated at all times can reduce the excess blood flow to the inflamed tooth that can make swelling increase and pain feel worse.
It sounds overly simplistic, but this small change can make a huge difference in tooth pain.
For sleeping, stay elevated with a wedge-shaped pillow or by stacking several standard pillows.
Keep your head elevated
FitPlus Wedge Pillow1.5 inches of memory foam to support your neck and shoulders for a comfortable sleep.
4. Keep the Area Cold
Frozen peas or a plastic Ziploc bag with half water and half ice works great to keep the toothache area cold and reduce swelling. Other patients I’ve seen like to freeze corn syrup in a Ziploc, since it doesn’t ever get hard like ice.
You can also try a wrap that lets you apply ice consistently to the area without having to hold it up to your face, like this one:
Hot or Cold Pack
LotFancy Reusable Pack4-pc gel pack with stretch wrap for pain relief. Chill or heat up then apply at the right temperature.
5. Garlic Paste
Garlic has medicinal and anti-bacterial properties that can kill dental bacteria that cause plaque, while also serving as an effective pain reliever. (4)
To try, use a garlic press to crush raw garlic before rubbing onto on the affected tooth.
6. Peppermint Tea
Some studies have shown that peppermint tea has antioxidant and antibacterial properties and can help in numbing painful areas. (5)
To give it a shot, brew a cup of peppermint tea, let it cool, and then swish around in the mouth. Add a bit of ice to cool it down faster.
Alternately, press the cooled (slightly warm is OK) tea bag against your painful tooth.
7. Knotted Floss
If your pain is caused by food stuck between the teeth, there’s a very simple solution that may entirely eliminate your need for a dentist.
The best way to tell if this is the problem is to identify the basic source of your pain. Is it tender gums somewhere near the space between teeth?
If so, knot a piece of floss and floss through your teeth. You’ll find out pretty quickly if your pain is caused by a bit of food—flossing it out will result in almost immediate relief.
How Will the Dentist Treat My Toothache?
When you’re finally able to make a dental appointment, ask the office if there’s anything they recommend to help you deal with your toothache in the meantime.
You should also record details about your pain—When did it start? How frequent is it? Is it radiating?—as well as possible causes of the toothache, like new foods or changes to your hygiene routine.
When you meet with your dentist, he will likely ask you for information about your pain, so it’s important to have as much accurate detail as possible.
Your dentist will conduct an exam to look more closely for the causes of your toothache. S/he’s searching for signs of things like a cracked tooth, cavity pain, or a damaged filling.
In order to diagnose your issue, an X-ray may need to be taken. An abscess, for example, may need an X-ray if you are free of other symptoms but your dentist suspects this “invisible” issue may be causing your toothache.
If the cause of tooth pain is root sensitivity, the dentist may give you a topical fluoride treatment and tips on how to avoid further erosion of the dentin.
If the cause of your pain is inflammation from a cavity, the dentist may recommend a filling or root canal.
The treatment of an abscess would depend on your particular case. If the abscess is in the gum, the dentist will need to drain it, clean it, and treat it.
If it’s in the tooth, he will probably drill a small hole in the tooth to allow the abscess to drain, before later performing a root canal. Or, if the abscess is large or the tooth is badly damaged, you may need to have the tooth removed.
You may also be prescribed antibiotics to aid the healing process and fight infection.
Should I Go to the Emergency Room for My Toothache?
- Have severe pain that persists for more than a day or two
- Get a fever
- Show symptoms of infection, such as swelling
- Notice your eyes swelling shut
- Struggle to breathe or swallow
- See your face has fallen
These are signs that the infection has started to spread, which can be dangerous for the body and is absolutely worthy of immediate medical attention.
There is no good severe toothache remedy you can perform at home, so don’t put it off if you’re having these symptoms.
What's the best way to prevent a toothache?
- Follow a healthy diet
- Brush correctly, using gentle, circular motions with a soft-bristled brush
- If you grind your teeth, look at getting your sleep apnea treated (which is the most likely reason for grinding)
- Mouth tape for better sleep and to ensure nose breathing
- Keep regular dental appointments so your dentist can catch any new cavities quickly and you have time to reverse them naturally
If you have toothaches due to root sensitivity, avoiding sugary and acidic foods can also be helpful.
What’s the best over-the-counter toothache medicine?
Why does my toothache come and go?
Other times, it might be an abscess flaring up and then healing enough that the pain subsides, even if the infection itself isn’t completely gone.
Cracked teeth also often have acute pain that fades and recurs as the pulp inside the tooth gets irritated or infected, heals, and then gets irritated again.
Can a toothache cause a headache?
Additionally, we often tense up other areas of the body like the jaw when our teeth hurt, which can lead to headaches. Other problems, like sinus infections, can sometimes radiate as both toothaches and headaches.
When do you need to take an antibiotic for tooth pain?
This is also a common prescription for the period of time before a root canal, in order to get the large infection under control before opening the tooth.
I’m taking amoxicillin for a toothache and it isn’t helping. What can I do?
When I prescribe amoxicillin to my patients, I tell them to contact me if their pain hasn’t improved within three days so that we can get them on a different treatment.
I’ve had a toothache for a month and nothing is working, but the pain only comes at night when I get ready to go to bed. What can I do to make it stop?
The pain is probably worse at night because you’re laying down, which increases the blood pressure to your tooth, since it’s at the same level as your heart.
You can try elevating your head and even your upper torso at night to relieve the pain, but that will only help relieve the pain a little. Ultimately, it’s important that you get treatment so your body can properly heal.
Should I use a hydrogen peroxide mouthwash to get rid of bacteria that’s causing my toothache?
Peroxide is highly antibacterial, which is actually not a good thing for your oral microbiome in the first place. (6) (That’s the reason I don’t recommend using essential oils in the mouth very often.)
However, the more serious reason you should avoid using hydrogen peroxide in the mouth is the increased risk of oral cancer. Some sources say this isn’t a possibility, but I prefer to err on the side of caution. (7, 8)
Final Thoughts on Toothaches
Not every toothache requires an immediate trip to the dentist, but they’re not something you should ignore.
Some common causes of toothaches include:
- Inflammation and cavity pain
- Root sensitivity
- Food stuck between the teeth
- Trauma to the teeth (grinding, car accident, etc.)
- Sinus infection
I’ve found the 3-3-3 method for toothache pain to work best: take 3 ibuprofen, 3 times a day, for 3 days.
Other ways to treat tooth pain at home include:
- Salt water rinse
- Clove oil
- High pillow
- Keeping the area cold
- Garlic paste
- Peppermint tea
- Knotted floss
If you’re in extremely severe pain or develop a fever, you should go to the ER for your toothache.
Mild pain may go away completely with these toothache home remedies. Moderate to severe pain that sticks around should send you to the dentist as soon as possible.
If you have any more questions about how to stop tooth pain, don’t hesitate to ask.Read Next: Reversing Tooth Decay and Healing Cavities Naturally: Top Questions Answered
- Selwitz, R. H., Ismail, A. I., & Pitts, N. B. (2007). Dental caries. The Lancet, 369(9555), 51-59. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/17208642
- Alqareer, A., Alyahya, A., & Andersson, L. (2006). The effect of clove and benzocaine versus placebo as topical anesthetics. Journal of dentistry, 34(10), 747-750. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/16530911
- Environmental Working Group. (2018). Eugenol. Retrieved from: https://www.ewg.org/skindeep/ingredient/702373/EUGENOL/
- Houshmand, B., Mahjour, F., & Dianat, O. (2013). Antibacterial effect of different concentrations of garlic (Allium sativum) extract on dental plaque bacteria. Indian journal of dental research, 24(1), 71. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/23852236
- Singh, R., Shushni, M. A., & Belkheir, A. (2015). Antibacterial and antioxidant activities of Mentha piperita L. Arabian Journal of Chemistry, 8(3), 322-328. Abstract: https://www.sciencedirect.com/science/article/pii/S1878535211000232
- Rashed, H. T. (2016). Evaluation of the effect of hydrogen peroxide as a mouthwash in comparison with chlorhexidine in chronic periodontitis patients: A clinical study. Journal of International Society of Preventive & Community Dentistry, 6(3), 206. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916793/
- Weitzman, S. A., Weitberg, A. B., Stossel, T. P., Schwartz, J., & Shklar, G. (1986). Effects of hydrogen peroxide on oral carcinogenesis in hamsters. Journal of Periodontology, 57(11), 685-688. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/3104570
- Munro, I. C., Williams, G. M., Heymann, H. O., & Kroes, R. (2006). Use of hydrogen peroxide‐based tooth whitening products and its relationship to oral cancer. Journal of Esthetic and Restorative Dentistry, 18(3), 119-125. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/16831183